Finding Medicare Plans in Maryland
Finding the right Medicare coverage can be daunting, even if you’ve enrolled before. We don’t think it has to be! We’ll help you sort through the variety of Medicare plans available in Maryland to find the coverage that’s right for you.
Who’s Eligible for Medicare Plans in Maryland?
Medicare is a federally sponsored program that provides healthcare services to those who qualify, by either age or disability/illness. Individuals generally become eligible for Medicare plans in Maryland once they reach 65 years of age. Persons under the age of 65 may also qualify if they have been receiving Social Security Disability Insurance (SSDI) for two years or have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End Stage Renal Disease (ESRD).
To qualify, you must be a citizen or permanent resident, having lived in the US for the past five years. In addition, you or your spouse must have worked and paid Medicare taxes for at least 10 years.
If you are unsure about your eligibility or will be turning 65 in the next six months, we’re here to help. Talk to a licensed insurance agent now by calling the number above.
What are the Different Medicare Plans in Maryland?
Original Medicare (Parts A and B)
Original Medicare is made up of two parts:
Part A (Hospital Insurance) covers inpatient services, like hospital care, care received at a skilled nursing facility, and hospice care.
Part B (Medical Insurance) covers outpatient medical services and supplies that are considered medically necessary. Part B also covers some preventive care, like flu shots and cardiovascular screenings.
It’s important to recognize that Original Medicare does not cover everything. For example, it generally does not cover prescription medications, hearing exams/hearing aids, long term care, dental care, or eyeglasses. That’s why there is a wide variety of different types of Medicare plans available, to help obtain a more comprehensive coverage.
Medicare Advantage Plans (Part C)
Medicare Advantage plans are provided by Medicare-approved private insurance companies and work as an alternative to Original Medicare (Parts A and B). These plans must provide the same coverage as Original Medicare (with the exception of hospice care, which remains covered by Part A). They can also provide additional benefits, such as dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
To enroll in a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. Premiums for these plans can start at $0, increasing with the level of coverage selected. You’ll need to continue paying your Part B premium in addition to your Part C premium.
Medicare Prescription Drug Plans (Part D)
Prescription Drug coverage is generally not covered by Original Medicare or Medigap Plans. Stand-alone Prescription Drug plans, offered by Medicare-approved private insurance companies, work alongside Original Medicare (Parts A and B) to add prescription drug coverage. With these plans, a tier system is used to grade medications, and copays/coinsurance for each medication are set in accordance with their tiers. Drugs graded in the lowest tiers have the lowest copays/coinsurance, and vice versa. Each plan provides a drug formulary for you to see which tier(s) your medications fall into. This allows you to compare plans and select one with the best overall value for your specific prescription needs.
Medicare Supplement Plans (Medigap)
Medicare Supplement plans add an additional layer of coverage to your Original Medicare by filling in coverage gaps. Medigap plans are provided by Medicare-approved private insurance companies and work alongside your Original Medicare to help reduce your out-of-pocket costs by paying certain healthcare costs, like copayments, coinsurance, and deductibles.
When Can I Enroll In A Plan?
Medicare Advantage and Medicare Prescription Drug Plans
You are first eligible to sign up for Medicare plans in Maryland during your Initial Enrollment Period (IEP). Your IEP starts three months before your 65th birthday month and continues for an additional three months. This means you have a total of seven months to enroll.
Following this period, you will be able to make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period occurs once per year, from October 15th to December 7th.
Key Fact: If you did not enroll in Original Medicare during your IEP, you will have another chance during the General Enrollment Period (GEP). This period starts on January 1st and runs until March 31st every year. Following this period, you will be able to select a Medicare Advantage plan from April 1st to June 30th.
Medicare Supplement Plans
Once you are 65 or older and enrolled in Medicare Part B, you will have an opportunity to enroll in the Medigap plan of your choice. Your Medigap Open Enrollment Period begins the same month as your Part B coverage and runs for the following six months.
Important Note: If you enroll during this period, you’re guaranteed the Medigap plan of your choice, regardless of any pre-existing conditions. But if you miss this window, carriers may charge you a higher premium or deny you coverage altogether.
Special Enrollment Periods
Special Enrollment Periods provide a way to make changes to your Medicare coverage outside of the usual periods. Special Enrollment Periods are granted to individuals who have recently experienced a qualifying life event. Qualifying life events include moving into or out of a care facility and moving out of state. Our team of licensed insurance agents can assist you in determining whether you qualify for a Special Enrollment Period.
How Can I Compare Plans?
MedicareMatchup provides a convenient way to explore the many Medicare plans available in Maryland to find the coverage you need. By working with trusted partners, we’ll help you find coverage that best suits your particular needs.
If you’re unsure about your eligibility or will be turning 65 within six months, we can give you some guidance and help you prepare for enrollment. Give us a call today or get plan information online using our simple form below.
Additional Medicare Resources in Maryland
Maryland’s State Health Insurance Program (SHIP) is a free services that helps people understand their health insurance benefits, bills, and rights through unbiased counseling and resources.
The Medicare Savings Program provides financial assistance to Medicare beneficiaries that have limited income and resources.
Sources: Medicare.gov; aging.maryland.gov